Project Lazarus is not only treating those who suffer from addiction, but is also changing the way chronic pain is treated… one county and city at a time.
In response to some of the highest drug overdose death rates in the country, Project Lazarus developed a community-based overdose prevention program in Wilkes County and western North Carolina that focused on increasing access to naloxone for prescription opioid users.
Our efforts over the last two years have prevented overdose deaths in Wilkes County. In a publication in Pain Medicine, we report that the overdose death rate dropped 42 percent from 2009 to 2010, with only four overdose deaths confirmed so far in 2011.
Forty-two percent looks like a large number, but not when considering the number of deaths we’re talking about.
Substance abuse related emergency department admissions dropped by 15.3% from 2008 to 2010.
This is the important statistic, and a moderate one at 15.3%, but still not very good considering the amount of regulation, restriction, and effort focused on opioids.
And considering the amount of risk factors assessed and involved before patients are allowed to use naloxone, I’m surprised this drug is helping at all.
As head of an agency [Fred Brason II, president and CEO of Project Lazarus, a nonprofit public health organization established in Wilkes County, N.C.] that works to increase public awareness about responsible pain management policies and provide substance abuse treatment… to empower communities and individuals to prevent drug overdoses and meet the needs of those living with chronic pain…
We work closely with Community Care of North Carolina’s (CCNC) Chronic Pain Initiative to help deliver better pain relief while reducing overdose risk at the same time. (CCNC is North Carolina’s non-profit Medicaid management entity.) The Chronic Pain Initiative seeks to address these challenges through a broad partnership that includes CCNC, the North Carolina Hospital Association, local hospitals and emergency departments, local health departments, primary care doctors, faith-based programs and law enforcement. CCNC is providing financial support and tapping into CCNC’s local networks – professionals who are expert in local conditions and resources for treatment.
Google identifies Community Care of North Carolina as a “health consultant.” Translation: management consultants.
But the organization, under the guidance of CEO Fred Wells Brason II, was also instrumental in bringing the first opioid treatment program (OTP) to Wilkes County North Carolina. It started as a buprenorphine clinic, which was more palatable to physicians, and then became a full-service OTP including methadone.
“Opioid Treatment Program” — that’s a new term for me. Might as well be “Chronic Pain Treatment Program.” Pain patients don’t need to be treated for pain, they need to be treated for opioid addiction. There, problem solved, according to these kinds of organizations.
In one meeting with them and Jana Burson, MD, from the OTP, one doctor said he didn’t want “those people in the waiting room with Grandma…”
“Those people”? And this, coming from a doctor? With a medical degree? I guess in North Carolina, drug addicts are worse than, what, black people?
The vast majority are on methadone because they cannot afford buprenorphine.
Only Medicaid patients are forced to use the more-dangerous methadone. (See other articles on this site for information on the dangers of methadone.)
Through a grant from Purdue Pharma, the Lazarus Project was able to provide naloxone kits at no charge to the OTP.
Big Pharma involvement, no surprise there. No doubt, there is also federal funds supporting this group, but I’m too tired to search for the link.
So far the OTP has documented four lives saved.
Out of how many?
Casey Reeves was one of the 18 people in Wilkes County who died of accidental opioid overdose in 2006.
In no way do I want to discount the number of lives lost, but for an “epidemic,” the number of people we’re talking about is very, very small.
Donna Reeves and her husband didn’t know about naloxone when their daughter died, but they do now. Reeves has helped Brason raise awareness in Wilkes County… Reeves said Casey probably died because she took the amount of the opioid drug that she’d gotten used to when she was using more frequently. But months of abstinence had lowered her body’s tolerance. Her old “usual” dose was enough to kill her.
Yes, abstinence can lower your body’s tolerance, but I have to wonder if naloxone can also be responsible for changing your brain’s chemistry and therefore creating a potential for overdose.
The unintentional-overdose rate remained high in 2009, when 30 Wilkes County residents died, resulting in a rate of 46.6 per 100,000. But in 2010, the numbers began to fall. “From 2009 to 2010, there was a 47 percent decrease in the number of deaths,” Brason said. In 2011, it dropped to 13 per 100,000.
Using these big numbers looks impressive, but appearances can be deceiving — which is why so many people use these figures to support whatever they’re selling.
By the end of 2014, the Project Lazarus model of educating patients and physicians will be deployed in all of North Carolina’s 100 counties through North Carolina’s Community Care networks, the organizations that manage the care for most of the state’s Medicaid patients… North Carolina’s military community has also embraced Project Lazarus principles, employing the model policies on Ft. Bragg. Brason also said the Eastern Band of Cherokee Indian Reservation has adopted the full Project Lazarus model, and that they’re seeing results.
I can’t say this enough… CHA CHING!
Brason, Sanford and Donna Reeves have all spoken to officials from federal agencies, including the Food and Drug Administration, to determine what needs to be done to make naloxone more available in community settings. When he went to the FDA hearings, Brason brought Reeves with him to testify as to the effects of opioid overdose on families and communities.
I’m sorry Mrs. Reeves’ daughter was a victim of the drug war, but using these parents to convince the FDA and Congress to make all of our lives miserable leaves me with little sympathy.
“I think of Casey every day, wondering if she’s proud of me, doing these things,” Reeves said. “And I think she’s proud of me.”
People will believe whatever they want to justify doing the wrong thing.